The United States Preventive Services Task Force updated its 2003 recommendations in a report released this week in the Annals of Internal Medicine. The panel suggests doctors not only screen patients for obesity, but also offer them help to lose weight.
The most effective weight-loss programs, the panel said, span 12 to 26 sessions a year and might include group sessions, weight-loss goal setting, exercise, self-monitoring, and sustaining healthy lifestyle changes.
Programs with a behavioral component have a good track record, the report noted, helping to reduce diabetes diagnoses, lower blood pressure, and reduce waist circumference. Still, those interventions produce an average weight loss of about six percent over a year (a five percent weight loss is considered clinically significant).
The panel didn’t give a nod to the use of medications such as orlistat and metformin. Both have been linked with weight loss and other health improvements, but weight-loss drug orlistat may have rare but serious side effects and metformin, a diabetes drug, isn’t approved for obesity treatment by the Food and Drug Administration.
In updating its previous recommendations the panel reviewed 58 studies on weight-loss interventions that didn’t involve surgery.
Although the country is in the midst of an obesity epidemic (two-thirds of the country is overweight or obese), doctors don’t always do a good job of counseling overweight patients.
Some physicians might tell patients they’re overweight but offer no follow-up, while others may not even bring up the subject. A January study in the journal Obesity found that a doctor’s own weight might be a factor in weight counseling.
Researchers at Johns Hopkins University found that 18 percent of overweight or obese doctors talked about losing weight with their patients. Among normal-weight doctors, 30 percent counseled patients in weight loss.
The panel said that more research is needed to look at how weight-loss screenings could affect obesity in the long run.
How do you think doctors should handle the topic of weight loss with their patients?